"All in One or (W)hole in One Repair" for Adult Total Brachial Plexus Palsy.

 Total brachial plexus palsy (TBPP) accounts for nearly 50% of all brachial plexus injuries. Since achieving a good functional hand was almost impossible, the aim was settled to get a good shoulder and elbow function. It was Gu, who popularized the concept of utilizing contralateral C7 (CC7) with vascularized ulnar nerve graft (VUNG) to get some hand function.

Modified Total Intrinsic Rehabilitation Procedure for Ulnar Palsy.

Tendon transfer for ulnar palsy has been an area of interest for many a stalwart in hand surgery, especially in southeast Asian countries, mainly because of the prevalence of Hansen's disease in these countries. Although the procedures look standardized, there are still many lacunae. Here in this article, we discuss about a surgical technique by which all the motor disabilities evolving due to ulnar nerve paralysis are addressed with three sets of tendon transfers performed in a single stage for: (1) key pinch restoration, (2) claw correction and adduction of fingers, and (3) claw correction and abduction of fingers.

The staged island flap: a new method of repair for thumb injuries.

An island flap from the middle finger is described which can be used to cover a terminal wound on the thumb and the adjacent palmar and dorsal defects of the thumb. The flap is transferred in two stages: the first stage ensures good skin cover using a simple technique and the second stage is nerve repair, giving good sensory return with correct cortical representation. Since 1977, 64 repairs have been carried out using this island flap.